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Pharmacopsychiatry 2018; 51(06): 243-250
DOI: 10.1055/s-0043-123471
Review
© Georg Thieme Verlag KG Stuttgart · New York

Cognitive Deficits in Methamphetamine Users: How Strong is The Evidence?

Lisa Proebstl
1   Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany
,
Felicia Kamp
1   Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany
,
Gabi Koller
1   Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany
,
Michael Soyka
1   Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany
2   Medical Park Chiemseeblick, Rathausstr. 25, 83233 Bernau am Chiemsee, Germany
› Author Affiliations
Further Information

Publication History

received 19 May 2017
revised 08 November 2017

accepted 16 November 2017

Publication Date:
15 January 2018 (online)

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Abstract

Methamphetamine use has spread in many European countries and the United States. The current review provides a summary and critical analysis of research on cognitive deficits associated with methamphetamine, also known as “crystal meth.” The literature search performed for this review led us to the hypothesis that methamphetamine use is associated with persistent changes in brain metabolism that result in various impairments, such as deficits in memory, attention, and concentration. The dopaminergic system in particular seems to be affected. Some studies indicate that cognitive impairments may improve when users become abstinent, but results of other studies are conflicting. This review discusses these findings and the consequences for the development of a specific addiction treatment for methamphetamine.

Key words

methamphetamine - cognition - deficits - cognitive impairment - executive function
 

  • References

  • 1 Barr A, Panenka W, MacEwan G. et al. The need for speed: an update on methamphetamine addiction. J Psychiatry Neurosci. 2006; 31: 301-313
    PubMedGoogle Scholar
  • 2 Matos E, Atzendorf J, Kraus L. et al. Substanzkonsum in der Allgemeinbevölkerung in Deutschland. SUCHT 2016; 62: 271-281
    CrossrefPubMedGoogle Scholar
  • 3 Pabst A, Kraus L, Matos E. et al. Substanzkonsum und substanzbezogene Störungen in Deutschland im Jahr 2012. SUCHT 2013; 59: 321-331
    CrossrefPubMedGoogle Scholar
  • 4 European Monitoring Centre for Drugs and Drug Addiction . Exploring methamphetamine trends in Europe. EMCDDA Papers Luxembourg: Publications Office of the European Union; 2014
    Google Scholar
  • 5 European Monitoring Centre for Drugs and Drug Addiction . European Drug Report 2016: Trends and Developments. EMCDDA Papers Luxembourg: Publications Office of the European Union; 2016;
    Google Scholar
  • 6 Cretzmeyer M, Sarrazin M, Huber D. et al. Treatment of methamphetamine abuse. Research findings and clinical directions. J Subst Abuse Treat. 2003; 24: 267-277
    CrossrefPubMedGoogle Scholar
  • 7 Hart C, Ward A, Haney M. et al. Methamphetamine self-administration by humans. Psychopharmacology (Berl) 2001; 157: 75-81
    CrossrefPubMedGoogle Scholar
  • 8 Härtel-Petri R. Crystal-Meth als Herausforderung für das Suchthilfesystem – Klinische Empfehlungen. Suchttherapie 2016; 17: 10-16
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Volkow N, Fowler J, Wang G. et al. Distribution and pharmacokinetics of methamphetamine in the human body: Clinical implications. PloS One 2010; 5: e15269
    CrossrefPubMedGoogle Scholar
  • 10 Förstl H. Neuro-Enhancement. Gehirndoping. Nervenarzt 2009; 80: 840-846
    CrossrefPubMedGoogle Scholar
  • 11 Franke A, Bonertz C, Christmann M. et al. Non-medical use of prescription stimulants and illicit use of stimulants for cognitive enhancement in pupils and students in Germany. Pharmacopsychiatry 2011; 44: 60-66
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Brecht M, O’Brien A, Mayrhauser C. et al. Methamphetamine use behaviors and gender differences. Addict Behav. 2004; 29: 89-106
    CrossrefPubMedGoogle Scholar
  • 13 Cruickshank C, Dyer K. A review of the clinical pharmacology of methamphetamine. Addiction 2009; 104: 1085-1099
    CrossrefPubMedGoogle Scholar
  • 14 Newton T, Kalechstein A, Duran S. et al. Methamphetamine abstinence syndrome: preliminary findings. Am J Addict. 2004; 13: 248-255
    CrossrefPubMedGoogle Scholar
  • 15 Aharonovich E. Cognitive impairment, retention and abstinence among cocaine abusers in cognitive-behavioral treatment. Drug Alcohol Depend. 2003; 71: 207-211
    CrossrefPubMedGoogle Scholar
  • 16 Scott J, Woods S, Matt G. et al. Neurocognitive effects of methamphetamine: a critical review and meta-analysis. Neuropsychol Rev. 2007; 17: 275-297
    CrossrefPubMedGoogle Scholar
  • 17 Hart C, Marvin C, Silver R. et al. Is cognitive functioning impaired in methamphetamine users? A critical review. Neuropsychopharmacology 2012; 37: 586-608
    CrossrefPubMedGoogle Scholar
  • 18 Nordahl T, Salo R, Leamon M. Neuropsychological effects of chronic methamphetamine use on neurotransmitters and cognition: a review. J Neuropsychiatry Clin Neurosci 2003; 15: 317-325
    CrossrefPubMedGoogle Scholar
  • 19 Dalley W, Fryer T, Brichard L. et al. Nucleus accumbens D2/3 receptors predict trait impulsivity and cocaine reinforcement. Science 2007; 315: 1267-1270
    CrossrefPubMedGoogle Scholar
  • 20 Reichel C, Gilstrap M, Ramsey L. et al. Modafinil restores methamphetamine induced object-in-place memory deficits in rats independent of glutamate N-methyl-D-aspartate receptor expression. Drug Alcohol Depend. 2014; 134: 115-122
    CrossrefPubMedGoogle Scholar
  • 21 Kesby J, Heaton R, Young J. et al. Methamphetamine exposure combined with HIV-1 disease or gp120 expression: comparison of learning and executive functions in humans and mice. Neuropsychopharmacology 2015; 40: 1899-1909
    CrossrefPubMedGoogle Scholar
  • 22 Bernheim A, See R, Reichel C. Chronic methamphetamine self-administration disrupts cortical control of cognition. Neurosci Biobehav Rev. 2016; 69: 36-48
    CrossrefPubMedGoogle Scholar
  • 23 Meredith C, Jaffe C, Kathleen S. Implications of chronic methamphetamine use: a literature review. Harv Rev Psychiatry 2005; 13: 141-154
    CrossrefPubMedGoogle Scholar
  • 24 Sulzer D, Sonders M, Poulsen N. et al. Mechanisms of neurotransmitter release by amphetamines: A review. Prog Neurobiol. 2005; 75: 406-433
    CrossrefPubMedGoogle Scholar
  • 25 Miller D, O’Callaghan J. Elevated environmental temperature and methamphetamine neurotoxicity. Environ Res. 2003; 92: 48-53
    CrossrefPubMedGoogle Scholar
  • 26 Cho A, Melega W. Patterns of methamphetamine abuse and their consequences. J Addict Dis. 2000; 21: 21-34
    PubMedGoogle Scholar
  • 27 Hornung J. The human raphe nuclei and the serotonergic system. J Chem Neuroanat. 2003; 26: 331-343
    CrossrefPubMedGoogle Scholar
  • 28 Volkow N, Chang L, Wang G. et al. Association of dopamine transporter reduction with psychomotor impairment in methamphetamine abusers. Am J Psychiatry. 2001; 158: 377-382
    CrossrefPubMedGoogle Scholar
  • 29 Chang L, Alicata D, Ernst T. et al. Structural and metabolic brain changes in the striatum associated with methamphetamine abuse. Addiction 2007; 102 (Suppl. 01) 16-32
    CrossrefPubMedGoogle Scholar
  • 30 Sekine Y, Minabe Y, Ouchi Y. et al. Association of dopamine transporter loss in the orbitofrontal and dorsolateral prefrontal cortices with methamphetamine-related psychiatric symptoms. Am J Psychiatry. 2003; 160: 1699-1701
    CrossrefPubMedGoogle Scholar
  • 31 Mackey S, Stewart J, Connolly C. et al. A voxel-based morphometry study of young occasional users of amphetamine-type stimulants and cocaine. Drug Alcohol Depend. 2014; 135: 104-111
    CrossrefPubMedGoogle Scholar
  • 32 Hall M, Alhassoon O, Stern M. et al. Gray matter abnormalities in cocaine versus methamphetamine-dependent patients: a neuroimaging meta-analysis. Am J Drug Alcohol Abuse. 2015; 41: 290-299
    CrossrefPubMedGoogle Scholar
  • 33 London E, Kohno M, Morales A. et al. Chronic methamphetamine abuse and corticostriatal deficits revealed by neuroimaging. Brain Res. 2015; 1628: 174-185
    CrossrefPubMedGoogle Scholar
  • 34 Johnson B, Roache J, Ait-Daoud N. et al. Effects of isradipine on methamphetamine-induced changes in attentional and perceptual-motor skills of cognition. Psychopharmacology (Berl) 2005; 178: 296-302
    CrossrefPubMedGoogle Scholar
  • 35 Mohs R, Tinklenberg J, Roth W. et al. Methamphetamine and diphenhydramine effects on the rate of cognitive processing. Psychopharmacology (Berl) 1978; 59: 13-19
    CrossrefPubMedGoogle Scholar
  • 36 Mohs R, Tinklenberg J, Roth W. et al. Sensitivity of some human cognitive functions to effects of methamphetamine and secobarbital. Drug Alcohol Depend. 1980; 5: 145-150
    CrossrefPubMedGoogle Scholar
  • 37 Silber B, Croft R, Papafotiou K. et al. The acute effects of d-amphetamine and methamphetamine on attention and psychomotor performance. Psychopharmacology (Berl) 2006; 187: 154-169
    CrossrefPubMedGoogle Scholar
  • 38 Lyoo I, Yoon S, Kim T. et al. Predisposition to and effects of methamphetamine use on the adolescent brain. Mol Psychiatry. 2015; 20: 1516-1524
    PubMedGoogle Scholar
  • 39 Cloak C, Alicata D, Chang L. et al. Age and sex effects levels of choline compounds in the anterior cingulate cortex of adolescent methamphetamine users. Drug Alcohol Depend. 2011; 119: 207-215
    CrossrefPubMedGoogle Scholar
  • 40 Thompson P, Hayashi K, Simon S. et al. Structural abnormalities in the brains of human subjects who use methamphetamine. J Neurosci. 2004; 24: 6028-6036
    CrossrefPubMedGoogle Scholar
  • 41 Casaletto K, Obermeit L, Morgan E. et al. Depression and executive dysfunction contribute to a metamemory deficit among individuals with methamphetamine use disorders. Addict Behav. 2015; 40: 45-50
    CrossrefPubMedGoogle Scholar
  • 42 Paulus M. Behavioral and functional neuroimaging evidence for prefrontal dysfunction in methamphetamine-dependent subjects. Neuropsychopharmacology 2002; 26: 53-63
    CrossrefPubMedGoogle Scholar
  • 43 Panenka W, Procyshyn R, Lecomte T. et al. Methamphetamine use: a comprehensive review of molecular, preclinical and clinical findings. Drug Alcohol Depend. 2013; 129: 167-179
    CrossrefPubMedGoogle Scholar
  • 44 Marshall J, O’Dell S. Methamphetamine influences on brain and behavior: unsafe at any speed?. Trends Neurosci 2012; 35: 536-545
    CrossrefPubMedGoogle Scholar
  • 45 North A, Swant J, Salvatore M. et al. Chronic methamphetamine exposure produces a delayed, long-lasting memory deficit. Synapse 2013; 67: 245-257
    CrossrefPubMedGoogle Scholar
  • 46 Huckans M, Fuller B, Chalker A. et al. Plasma inflammatory factors are associated with anxiety, depression, and cognitive problems in adults with and without methamphetamine dependence: an exploratory protein array study. Front Psychiatry 2015; 6: 178
    PubMedGoogle Scholar
  • 47 Simon S, Dacey J, Glynn S. et al. The effect of relapse on cognition in abstinent methamphetamine abusers. J Subst Abuse Treat. 2004; 27: 59-66
    CrossrefPubMedGoogle Scholar
  • 48 Drechsler R. Exekutive Funktionen. Z Neuropsychol 2007; 18: 233-248
    CrossrefPubMedGoogle Scholar
  • 49 Everitt B, Robbins T. From the ventral to the dorsal striatum: devolving views of their roles in drug addiction. Neurosci Biobehav Rev. 2013; 37: 1946-1954
    CrossrefPubMedGoogle Scholar
  • 50 Garavan H, Stout J. Neurocognitive insights into substance abuse. Trends Cogn Sci. 2005; 9: 195-201
    CrossrefPubMedGoogle Scholar
  • 51 Verdejo-Garcia A, Bechara A, Recknor E. et al. Executive dysfunction in substance dependent individuals during drug use and abstinence: An examination of the behavioral, cognitive and emotional correlates of addiction. J Int Neuropsychol Soc. 2006; 12: 405-415
    PubMedGoogle Scholar
  • 52 May A, Stewart J, Migliorini R. et al. Methamphetamine dependent individuals show attenuated brain response to pleasant interoceptive stimuli. Drug Alcohol Depend. 2013; 131: 238-246
    CrossrefPubMedGoogle Scholar
  • 53 Chen Y, Chen C, Wang L. Predictors of relapse and dropout during a 12-week relapse prevention program for methamphetamine users. J Psychoactive Drugs. 2015; 47: 317-324
    CrossrefPubMedGoogle Scholar
  • 54 Rusyniak D. Neurologic manifestations of chronic methamphetamine abuse. Psychiatr Clin North Am. 2013; 36: 261-275
    CrossrefPubMedGoogle Scholar
  • 55 Hosak L, Preiss M, Bazant J. et al. Comparison of Wisconsin Card Sorting Test results between Czech subjects dependent on methamphetamine versus healthy volunteers. Psychiatr Danub 2012; 24: 188-193
    PubMedGoogle Scholar
  • 56 Kane M, Engle R. Working-memory capacity and the control of attention. The contributions of goal neglect, response competition, and task set to Stroop interference. J Exp Psychol Gen 2003; 132: 47-70
    CrossrefPubMedGoogle Scholar
  • 57 Salo R, Nordahl T, Natsuaki Y. et al. Attentional control and brain metabolite levels in methamphetamine abusers. Biol Psychiatry. 2007; 61: 1272-1280
    CrossrefPubMedGoogle Scholar
  • 58 Salo R, Nordahl T, Possin K. et al. Preliminary evidence of reduced cognitive inhibition in methamphetamine-dependent individuals. Psychiatry Res. 2002; 111: 65-74
    CrossrefPubMedGoogle Scholar
  • 59 Salo R, Nordahl T, Galloway G. et al. Drug abstinence and cognitive control in methamphetamine-dependent individuals. J Subst Abuse Treat. 2009; 37: 292-297
    CrossrefPubMedGoogle Scholar
  • 60 Jaffe C, Bush K, Straits-Troster K. et al. A comparison of methamphetamine-dependent inpatients childhood attention deficit hyperactivity disorder symptomatology. J Addict Dis. 2015; 24: 133-152
    PubMedGoogle Scholar
  • 61 Wang G, Volkow N, Chang L. et al. Partial recovery of brain metabolism in methamphetamine abusers after protracted abstinence. Am J Psychiatry. 2004; 161: 242-248
    CrossrefPubMedGoogle Scholar
  • 62 Boileau I, Rusjan P, Houle S. et al. Increased vesicular monoamine transporter binding during early abstinence in human methamphetamine users: Is VMAT2 a stable dopamine neuron biomarker?. J Neurosci 2008; 28: 9850-9856
    CrossrefPubMedGoogle Scholar
  • 63 Kalechstein A, Newton T, Green M. Methamphetamine dependence is associated with neurocognitive impairment in the initial phases of abstinence. J Neuropsychiatry Clin Neurosci 2003; 15: 215-220
    CrossrefPubMedGoogle Scholar
  • 64 Ersche K, Clark L, London M. et al. Profile of executive and memory function associated with amphetamine and opiate dependence. Neuropsychopharmacology 2006; 31: 1036-1047
    CrossrefPubMedGoogle Scholar
  • 65 Chang L, Ernst T, Speck O. et al. Perfusion MRI and computerized cognitive test abnormalities in abstinent methamphetamine users. Psychiatry Res. 2002; 114: 65-79
    CrossrefPubMedGoogle Scholar
  • 66 Homer B, Solomon T, Moeller R. et al. Methamphetamine abuse and impairment of social functioning: A review of the underlying neurophysiological causes and behavioral implications. Psychol Bull. 2008; 134: 301-310
    CrossrefPubMedGoogle Scholar
  • 67 Zhong N, Jiang H, Du J. et al. The cognitive impairments and psychological wellbeing of methamphetamine dependent patients compared with health controls. Prog Neuropsychopharmacol Biol Psychiatry. 2016; 69: 31-37
    CrossrefPubMedGoogle Scholar
  • 68 Janetsian S, McCane A, Linsenbardt D. et al. Methamphetamine-induced deficits in social interaction are not observed following abstinence from single or repeated exposures. Behav Pharmacol. 2015; 26: 786-797
    CrossrefPubMedGoogle Scholar
  • 69 Cherner M, Suarez P, Casey C. et al. Methamphetamine use parameters do not predict neuropsychological impairment in currently abstinent dependent adults. Drug Alcohol Depend. 2010; 106: 154-163
    CrossrefPubMedGoogle Scholar
  • 70 Rezapour T, DeVito E, Sofuoglu M. et al. Perspectives on neurocognitive rehabilitation as an adjunct treatment for addictive disorders: from cognitive improvement to relapse prevention. Prog Brain Res. 2016; 224: 345-369
    PubMedGoogle Scholar
  • 71 Dean A, London E, Sugar C. et al. Predicting adherence to treatment for methamphetamine dependence from neuropsychological and drug use variables. Drug Alcohol Depend. 2009; 105: 48-55
    CrossrefPubMedGoogle Scholar
  • 72 Streeter C, Terhune D, Whitfield T. et al. Performance on the Stroop predicts treatment compliance in cocaine-dependent individuals. Neuropsychopharmacology 2008; 33: 827-836
    CrossrefPubMedGoogle Scholar
  • 73 Soyka M, Koller G, Proebstl L. et al. [Prevalence and therapy of crystal methamphetamine dependence]. Fortschr Neurol Psychiatr. 2017; 85: 92-99
    Article in Thieme ConnectPubMedGoogle Scholar
  • 74 Lawton-Craddock A, Nixon S, Tivis R. Cognitive efficiency in stimulant abusers with and without alcohol dependence. Alcohol Clin Exp Res. 2003; 27: 457-464
    CrossrefPubMedGoogle Scholar
  • 75 Agrawal A, Neale M, Prescott C. et al. A twin study of early cannabis use and subsequent use and abuse/dependence of other illicit drugs. Psychol Med. 1999; 34: 1227-1237
    PubMedGoogle Scholar
  • 76 Gonzalez R, Rippeth J, Carey C. et al. Neurocognitive performance of methamphetamine users discordant for history of marijuana exposure. Drug Alcohol Depend. 2004; 76: 181-190
    CrossrefPubMedGoogle Scholar
  • 77 Cuzen N, Koopowitz S, Ferrett H. et al. Methamphetamine and cannabis abuse in adolescence: A quasi-experimental study on specific and long-term neurocognitive effects. BMJ Open 2015; 5: e005833
    CrossrefPubMedGoogle Scholar
  • 78 Cadet J, Krasnova I. Interactions of HIV and methamphetamine: cellular and molecular mechanisms of toxicity potentiation. Neurotox Res. 2007; 12: 181-204
    CrossrefPubMedGoogle Scholar
  • 79 van Gorp W, Hinkin C. Triple trouble: Cognitive deficits from hepatitis C, HIV, and methamphetamine. Neurology 2005; 64: 1328-1329
    CrossrefPubMedGoogle Scholar
  • 80 Rippeth J, Heaton R, Carey C. et al. Methamphetamine dependence increases risk of neuropsychological impairment in HIV infected persons. J Int Neuropsychol Soc. 2004; 10: 1-14
    CrossrefPubMedGoogle Scholar
  • 81 Sofuoglu M, DeVito E, Waters A. et al. Cognitive enhancement as a treatment for drug addictions. Neuropharmacology 2013; 64: 452-463
    CrossrefPubMedGoogle Scholar
  • 82 Brewer J, Worhunsky P, Carroll K. et al. Pretreatment brain activation during Stroop task is associated with outcomes in cocaine-dependent patients. Biol Psychiatry. 2008; 64: 998-1004
    CrossrefPubMedGoogle Scholar
  • 83 Hentschel H. Ecstasy und co. – sind Partydrogen wirklich harmlos? Refresher course. Aktuelles Wissen für Anästhesisten 2001; 27: 157-172
    PubMedGoogle Scholar
  • 84 Bray G. Use and abuse of appetite-suppressant drugs in the treatment of obesity. Ann Intern Med. 1993; 7: 707-713
    PubMedGoogle Scholar
  • 85 Perez-Reyes M, White W, McDonald S. et al. Clinical effects of daily amphetamine administration. Clin Neuropharmacol. 1991; 14: 352-358
    CrossrefPubMedGoogle Scholar
  • 86 Logan B. Methamphetamine – effects on human performance and behavior. Forensic Sci Rev 2002; 14: 133-151
    PubMedGoogle Scholar
  • 87 Dirks H, Esser S, Brockmeyer N. et al. Dramatic changes over time of methamphetamine intake in a German, HIV-positive, sample of men who have sex with men (MSM). Pharmacopsychiatry 2017; 50: 123-124
    Article in Thieme ConnectPubMedGoogle Scholar
  • 88 Dinger J, Hinner D, Reichert J. et al. Methamphetamine consumption during pregnancy – effect on child health. Pharmacopsychiatry 2017; 50: 107-113
    Article in Thieme ConnectPubMedGoogle Scholar